We can't afford to be squeamish about saving lives

An ethical dilemma is now a literal case of life and death

Deborah Orr,Columnist
Wednesday 08 November 2000 01:00 GMT
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The operation is over, and Jodie is no longer conjoined to her twin, Mary. An ethical dilemma is now a literal case of life and death. Jodie is hanging on to an uncertain future, monitored second by second for the next few days, living in hospitals for perhaps the next five years. Mary no longer exists, though some people argued from the start that hers was never a human life.

The operation is over, and Jodie is no longer conjoined to her twin, Mary. An ethical dilemma is now a literal case of life and death. Jodie is hanging on to an uncertain future, monitored second by second for the next few days, living in hospitals for perhaps the next five years. Mary no longer exists, though some people argued from the start that hers was never a human life.

No doubt her parents, their views ridden over roughshod for months now, will be allowed to give the remains of their daughter a Christian, human, burial. This, even though events have proven that their own belief in their daughter's spiritual existence as an individual entity with normal human rights means next to nothing.

The moral philosopher Mary Warnock suggested early on in the controversy: "There are those who, without repudiating religion, are capable of taking a developmental or biological view of human life. According to this view, Mary's life would hardly be regarded as the life of a human being, let alone one with an immortal soul.

"It would more plausibly be regarded as an assemblage of human tissues that would never result in a human person, and the removal of which from Jodie could be regarded as analogous to the removal of a tumour, an unwanted and destructive growth of cells, which are undoubtedly human cells, and alive, but are nevertheless not and never will be a human being."

And so it has been. Now all that is left of Mary's life are memories of her, and for her twin not just the scars but, apparently, the physical space that until the night before last she took beside her twin. In a statement to the press yesterday, Professor Lewis Spitz, consultant paediatric surgeon at Great Ormond Street Hospital, brought home in his practical way just what sort of a gap Mary will leave in Jodie's life.

Professor Spitz, who did not take part in the complex operation that divided Jodie and Mary, but who has operated on other conjoined twins, suggested that her aftercare might include some "little tricks". One of these tricks is to place a mirror beside the remaining twin, to help her cope with the stress of losing her sister.

No doubt this stress is partly physical. But it still reminds me of a sad fact I read a few years ago. According to researchers into twins in the US, very many of us had been twins for a time in the womb, without even knowing it. The researchers suggested that people who described their life as feeling "incomplete" or who always carry a sense that something that they cannot put their finger on is missing from their life, are probably twins whose sibling was lost very early in the process of conception and development. Do doctors place mirrors in babies' beds to trick them out of missing their tumours? Not that I know of.

However, now that the deed is done, it is best not to be too churlish. The case of Jodie and Mary is extremely unusual, as we have again and again been told. No precedents are likely to have been set by this particularly difficult and disturbing case. And anyway, Jodie's life has been saved. One of these two lives has been saved. That, according to the law of the land, has justified everything.

Which is why it is so very odd that the Royal Society's working party report on stem-cell cloning should arrive in Parliament on the very first morning that began with Jodie alive and Mary dead. The report is very much in favour of the Government lifting the ban on cloning for the purposes of stem-cell research, on the grounds that this research could eventually lead to treatments for a raft of illnesses, thus exercising a positive effect on the quality of life of around 10 per cent of the population.

Astoundingly, in a country which judges that a living person can be operated out of existence to save the life of another, it is far from certain that this research will get the go ahead. What is the problem here? No life will be extinguished to do this work. Instead, stem-cells from pinhead-sized embryos will be reproduced, so that scientists can work out how to programme them to develop into replacements for diseased cells.

This, to me, sounds like an astounding breakthrough. To Parliament, though, it appears to be an untempting prospect. At the beginning of the month, Evan Harris, the Liberal Democrat spokesman on science, proposed that embryos under 14 days old should be used in stem-cell research. His backbench bill, proposed to "test opinion", was defeated by a resounding 175 to 83. This despite the fact that the Prime Minister himself is known to be in favour of the change in the law, even though he has not spoken out on the subject in public. None of this bodes well for the upcoming free vote on this issue in the House of Commons.

Meanwhile, even those most ardently in favour of the change in the law use the flimsiest, rather than the strongest, of arguments in their favour. Professor Richard Gardner, chairman of the Royal Society's working party, is obviously committed to the development for scientific reasons alone. However, instead of sticking with those arguments, he appeals to "national pride" and economic competitiveness by suggesting that without the opportunity to continue research in this country, this largely British innovation will go abroad. Professor Gardner warns that other countries will press ahead with this research, and that our scientists will go abroad to work on this research. Eventually this will mean that British people wishing to have stem-cell therapy will either have to go abroad or will have to attempt to import the necessary tissue.

No doubt the international disparity that will develop if Britain is not allowed to carry on its experiments is a practical issue. But surely it is a side issue compared to the job of emphasising the real ones at stake here, and fighting the artificial ones which invoke the spectre of the "slippery slope" or the monster of "moral degeneracy."

How tacky it is that arguments proclaiming the national interest should be invoked in such matters, as if these considerations are more important that doing the best that we can to save or to enhance human life. It is no more tacky, however, than an ethical debate which is driven by an irrational fear of anything that may have figured in the science fiction of the last century.

The development of cell-based treatment is expected in fewer than two decades to be able to cure Parkinson's disease, some cancers, diabetes and other illnesses. In other words it will be able to cure many, many actual people. Would we, confronted with an individual dilemma, deny life, condemn a person to suffer and die, because we feel a medical procedure is a bit creepy, a bit outlandish?

We didn't in Jodie's case, even though that meant sacrificing a human life. No such sacrifice needs to be made here, although millions of lives will eventually be saved by such a move. So what is it that we are being so squeamish about? The way the replicants started going all weird in the film Blade Runner?

* d.orr@independent.co.uk

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